Insurance, Treatment Costs & Financial Assistance

Ask treatment providers about sliding-fee scales, scholarships, grants, charity care, state-funded programs, and payment plans. Availability, eligibility, and terms vary.

Call script: “I’m comparing treatment options and have limited resources. Do you offer financial assistance, a sliding scale, scholarships, state-funded services, or payment plans? What costs are not included?”

• SAMHSA: free and low-cost treatment options
• Search FindTreatment.gov

Marketplace plans cover mental health and substance use disorder services as essential health benefits. Specific benefits depend on the state and plan. Ask your insurer which services and facilities are covered, whether prior authorization is needed, and what deductibles and copayments may apply.

• HealthCare.gov: mental health and substance use coverage
• U.S. Department of Labor: parity protections

Medicaid substance use disorder benefits and provider participation vary by state and plan. Medicare covers certain screenings, services, and programs for mental health and substance use disorders; service rules and costs vary.

Confirm your specific benefits and a provider’s participation with your plan or state Medicaid office before making a decision.

• Medicaid.gov: substance use disorder resources
• Medicare.gov: mental health and substance use coverage
• Medicare.gov: opioid use disorder treatment

State behavioral health agencies may describe public treatment services for eligible residents. Programs, eligibility, and available funding differ by state. Search your state’s resources and ask providers about waitlists and current openings.

For Texas residents, HHSC’s OSAR program can be a starting point for information about substance use services.

• Find state treatment agencies
• Texas HHSC: OSAR services

Costs can vary by location, level of care, length of treatment, services, and coverage. A higher price does not by itself show which care is appropriate; ask a qualified professional about clinical needs.

Before agreeing to care, request a written estimate and ask what is included, what may cost extra, whether insurance is accepted, and what assistance or payment-plan terms are available.

• FindTreatment.gov: understanding treatment costs and payment
• SAMHSA: questions about lower-cost care

• SAMHSA FindTreatment.gov treatment locator
• SAMHSA free and low-cost treatment guide
• HRSA Find a Health Center
• HealthCare.gov coverage information
• Texas HHSC OSAR, for Texas residents